Three rabbinical figures with extensive experience with bris milah and metzitza b’peh (mbp), have written New York Mayor Bill de Blasio to stress their communities’ continued readiness to abide by the entire agreement reached with the mayor in 2015 to reduce the risk of – and accurately identify the source of – herpes simplex virus (HSV-1) infection of newborns.

The rabbonim, Rav Shraga Feivel Cohen, Rav Avrohom S. Blum and Rav Yitzchok Eichenstein, representing the Vaad L’mishmeres Ha’bris – a rabbinical group that has been involved in the ongoing dialogue regarding mbp – state at the start that they fully share the goal of doing everything possible to safeguard the health and wellbeing of children, while at the same time respecting the religious freedom of those for whom the millennia-old minhag of mbp is an essential component of their sacred religious tradition. The two goals, they insist, are entirely compatible.

The 2015 agreement, they reminded the mayor, established a clear protocol in cases of HSV-1 infection of an infant. HSV-1 is the common “cold sore” virus that causes harmless lesions in adults but can be life-threatening to a newborn – although cases of infant infection from circumcision are extremely rare, and although the prognosis in the rare cases of infection is greatly improved with early diagnosis and treatment. The investigative protocol includes immediate testing of the mohel for presence of HSV-1 antibodies, which would indicate a previous or current infection with the virus, and then DNA testing to ascertain if the source of the infection was in fact the mohel. And if it was, the mohel would desist from practicing mbp.

Unfortunately, the rabbonim note, when they endeavored to follow up on implementation of the protocols agreement, they were informed that the City Health Department refused to commit to terms of the agreement. Several subsequent attempts were made to revive the agreement, but the Health Department refused to abide by its terms.

The DNA testing, the rabbis explain, is vital, as there have been clear cases where a mohel was suspected of being the source of a baby’s infection but where such testing showed conclusively that the virus had been transmitted by someone else. Accurately confirming the source of the infection is imperative – whether it be the mohel, a parent or another caregiver – in order to prevent subsequent transmission of such infections.

The letter decries a recent Health Department alert implying that six mohelim associated with cases of infant herpes infections were the source of the infections, although no DNA testing was done, and none offered by the department.

The rabbonim end their letter with an urgent request that the protocol agreed upon two years ago finally be implemented, and that they and their communities look forward to working with City Hall to “bring to fruition our historic agreement that protect[s] both religious freedom and the health of our precious children.”